某 新邪咳嗽气急,右胁刺痛,宜防血溢之变(五月初三日。)
干地龙(钱半) 枳壳(钱半) 金沸草(三钱) 光杏仁(三钱) 象贝(三钱) 广郁金(三
钱)
焦栀子(三钱) 马兜铃(一钱) 白前(钱半) 橘络(钱半) 前胡(钱半) 鲜竹肉(一丸)
二帖。
介按∶此是温邪烁肺,故治以清肺宁络之方。
安昌徐 咳呛不已,脉弦细,口甜,舌色嫩黄。宜清肺胃以化痰。
栝蒌皮(三钱) 仙半夏(钱半) 广橘红(一钱) 金沸花(三钱,包煎) 光杏仁(三钱)
炒川
连(七分) 茯苓(四钱) 石决明(五钱) 紫菀(钱半) 白前(钱半) 冬瓜子(三钱) 川贝(
钱半)
清煎四帖。
介按∶肝热烁肺,脾湿酿痰,此方清宣肺气,兼平肝热。又佐渗湿化痰为治。
某 咳痰不爽,脉弦,舌微白,脐下气机不运。姑宜清气消痰为主(四月念三日。)
栝蒌皮(三钱) 霜桑叶(三钱) 金沸花(三钱,包煎) 炒枳壳(钱半) 川贝(钱半) 石
决明(六钱) 广郁金(一钱) 新会皮(钱半) 光杏仁(三钱) 白前(钱半) 焦栀子(三钱)
清煎三帖。
介按∶肝阳逆阻枢机,以致肺气不宣。治以清宣肺痹,平肝理气,庶几痰蠲肝和,而诸
恙自瘳。
安昌高 舌白滑,脉细数,咳嗽痰迷,咯不易出,气逆,周身骨骱痛。宜防损。(五月
念三日。)
北沙参(三钱) 生石决明(六钱) 甜杏仁(三钱) 炙甘草(八分) 茯苓(四钱) 川贝(
二钱) 怀药(二钱) 冬瓜子(三钱) 生地(三钱) 紫菀(钱半) 盐水炒橘红(一钱)
清煎五帖。
又 咳不减,喉中贮痰不爽,咳不易出,脉濡细,舌滑,头晕肢楚。宜清气熄风,利湿
化痰(六月初五日)。
栝蒌皮(三钱) 煨天麻(八分) 冬瓜子(三钱) 生石决明(四钱) 川贝(三钱) 白蒺藜
(三钱) 茯苓(四钱) 通草(钱半) 甘菊(钱半) 光杏仁(三钱) 广橘红(一钱)
清煎四帖。
又 湿酿成痰,喉中咯不易出,舌滑,大便不快。仍遵前法损益。
栝蒌皮(三钱) 金沸花(三钱,包煎) 川贝(二钱) 通草(钱半) 广橘红(一钱) 广郁
金(三钱) 杏仁(三钱) 焦山栀(三钱) 茯苓(四钱) 紫菀(钱半) 桑叶(三钱)
清煎四帖。
介按∶肝阳上越,挟湿化痰,阻滞气机,以致咳嗽而咯痰不爽。初方健脾养胃,清肺渗
湿,继则参以平肝熄风,终则清宣肺气,兼渗湿热。三方之中,以次方尤为灵动。
某 湿热酿痰,脉濡细,舌微白,咳逆,右胁刺痛,溲溺赤,腹痛。宜清气、和络、化
痰。
栝蒌皮(三钱) 枳壳(钱半) 光杏仁(三钱) 降香(七分) 广郁金(三钱) 象贝(三钱)
丝瓜络(三钱) 橘红(一钱) 干地龙(钱半) 通草(钱半) 白前(钱半)
清煎二帖。
介按∶湿痰阻肺,以致咳久胁痛,故治以渗湿化痰兼和络。
大西庄宋 呛咳喉痒,脉弦细,舌转微白,潮热较差,食入恶心。宜清肺胃化痰。(四
月十六号癸卯二十九日。)
紫菀(二钱) 光杏仁(三钱) 炒谷芽(四钱) 白前(钱半) 川贝(钱半) 茯苓(四钱)
蔻壳(一钱) 橘红(一钱) 仙半夏(钱半) 青蒿梗(一钱) 通草(钱半)
清煎三帖。
又 潮热不清,脉弦细数,咳嗽如前,溲溺赤。宜清热、通肺、化痰,防血溢。(四月
念三号甲辰初七日。)
秦艽(钱半) 霜桑叶(三钱) 白前(钱半) 焦山栀(三钱) 丹皮(二钱) 川贝(二钱)
广橘红(一钱) 通草(钱半) 青蒿梗(一钱) 地骨皮(三钱) 杏仁(三钱)
清煎三帖。
介按∶阴虚热盛,灼液成痰而为咳嗽,今以舌转微白,继则溲溺变赤,是属更感新邪之
候,
肺胃叠次受戕,肝阳上越莫制。前后两方,既清内热,又祛新邪。但阴液骤难恢复,已属难
治之症,后闻斯人于六月望边竟至不起。录之以为辨证之一助。
遗风庞 咳嗽不已,脉尚虚数,胃纳已和。宜润肺以清降。(四月十二日。)
生玉竹(三钱) 霜桑叶(三钱) 栝蒌皮(三钱) 马兜铃(一钱) 川贝(钱半) 茯神(四
钱) 光杏仁(三钱) 款冬花(三钱) 白前(钱半) 广橘络(钱半) 焦山栀(三钱) 生石决明(五
钱)
清煎四帖。
介按∶此方清肺养胃以柔肝,为治咳嗽善后之妙剂。
安昌施 咳嗽未除,脉小数,仍属汗出,微热已退,姑宜清肺敛液(五月一号甲辰十五
日。)
北沙参(三钱) 紫菀(二钱) 白薇(三钱) 白石英(三钱) 茯神(四钱) 川贝(钱半)
炒白芍(钱半) 炙橘红(一钱) 生牡蛎(四钱) 甜杏仁(三钱) 炒枣仁(三钱)
清煎四帖。
介按∶心在天为热,其液为汗,兹以心火不宁,刑肺咳嗽,气泄而身热汗出,故以补益
心神,敛液清肺为治。
安昌王(年五十余岁) 酒湿伤肺,咳嗽气急,痰稠,脉滑数,舌赤,苔薄腻。尤防变幻
,候正。(八月六日丁未念四日)
栝蒌皮(三钱) 广橘红(一钱) 原滑石(四钱) 炒知母(钱半) 象贝(三钱) 天竺黄(
钱半)
广郁金(三钱) 前胡(钱半) 光杏仁(三钱) 生菔子(二钱) 法半夏(钱半) (引)枇杷叶
(五片)
一帖。
介按∶酒湿酿痰,壅滞气机,肺失治节之权,而气急咳嗽,兹以清肺气而涤稠痰,方虽
对证
。但高年患此,是属危险重症。案中尤防变幻之语,洵是经验之谈。后闻斯人,只过四五日
而逝世,可见医家临证,全在诊断确凿,审慎周详也。
安昌李(妇) 呕减热缓,呛咳渴饮,脉滑数,经停月余,小溲稍利,偶有呃逆,脘痛。
宜宣肺、和中、化痰。(九月补五日。)
栝蒌皮(三钱) 射干(钱半) 广橘白(一钱) 白前(二钱) 广郁金(三钱) 光杏仁(二
钱) 焦山栀(三钱) 柿蒂(七只) 川贝母(二钱) 霜桑叶(三钱) 天花粉(三钱) (引)枇杷叶(
五片)
三帖。
又 呕逆已瘥,脉小滑,经停月余,呛咳脘闷,气冲欲呕。宜清养肺胃化痰。(九月初
九日。)
黄草斛(三钱) 川贝(钱半) 大腹绒(三钱) 藿梗(二钱) 橘白(一钱) 扁豆衣(三钱)
广
郁金(三钱) 绿萼梅(钱半) 桑叶(三钱) 炒谷芽(四钱) 蔻壳(钱半) 鲜枇杷叶(七片,
去毛)
三帖。
又 呛咳未除,舌红,潮热,脉滑数,经停,胸闷心惕。宜清养肺胃为主。(九月十三
日。)
南沙参(三钱) 冬桑叶(三钱) 橘红(一钱) 炒知母(钱半) 地骨皮(三钱) 川贝母(
钱半)
谷芽(钱半) 绿萼梅(钱半) 银胡(一钱) 紫菀(二钱) 黄草石斛(三钱) 鲜枇杷叶(七片)
三帖。
介按∶肝经郁热上升,犯胃则呕恶呃逆,冲肺则咳呛脘闷,日久而痰气凝滞,经隧不宣
。初方宣肺化痰,继则养胃清肝,终则又参入滋液退热。方法颇有次序。
大西庄沈(妇) 气喘呛咳,右脉小数,左关弦细,舌灰黄底红,癸水不调,外寒内热,
胃钝便闭。宜防血溢。(十月初九日。)
霜桑叶(三钱) 光杏仁(三钱) 栝蒌皮(三钱) 南沙参(三钱) 川贝(二钱) 甘菊(二
钱) 焦山栀(三钱) 橘红(一钱) 紫菀(钱半) 白前(钱半) 谷芽(四钱) (引)枇杷叶(五片,
去毛)
三帖。
介按∶肝阴素亏,厥阳上冲肺胃,肺气失于清肃,以致咳喘而大便不爽,兼以阴虚内热
,阳微外寒。治以清宣肺痹,养胃液而制肝逆。
柯桥王 咳嗽较减,脉虚,左弦细,腰疼,癸涩早期,还宜前法加减为妥。
紫菀(二钱) 南沙参(三钱) 川断(三钱) 当归(钱半) 川贝(钱半) 甜杏仁(三钱)
炒杜
仲(二钱) 炒白芍(钱半) 丹皮(三钱) 橘络(钱半) 生地(四钱,砂仁五分拌炒) 小橘饼
(三枚)
四帖。
介按∶经水趱早,血热之征,脉虚腰疼,肾虚之候。咳嗽略减,是肺气略见清肃。脉虚
而细,是胃液尚未恢复。故其方法,既以清养肺胃,又佐滋液补肾。
遗风庞(妇) 呛咳头晕,左脉弦细,气口搏大,形寒,钝胃,经停二月余。宜清肺胃熄
风。(三月念号癸卯初二日。)
南沙参(三钱) 桔梗(钱半) 谷芽(四钱) 桑叶(三钱) 苏梗(钱半) 川贝(二钱) 川
断(三钱) 甘菊(钱半) 紫菀(二钱) 光杏仁(三钱) 炒杜仲(三钱)
清煎四帖。
介按∶肝阳化风,旋扰不息,时届春令,肝阳愈旺,更受外风,逆乘肺胃,遂致呛咳头
晕。兹以柔肝养胃,清肺疏风,乃是对症疗法。
遗风庞(妇) 咳嗽稍减,腹中瘕块不利,呕恶涎沫,癸不及期。宜清肺、平肝、调经。
紫菀(钱半) 生牡蛎(四钱) 仙半夏(钱半) 茺蔚子(三钱) 川贝(钱半) 香附(三钱)
广
橘红(一钱) 玫瑰花(五朵) 甜杏仁(三钱) 钗斛(三钱) 生款冬(三钱) 枇杷叶(五片,
去毛)
四帖。
介按∶冲脉为病,气逆里急,在男子则为内疝,女子则为瘕聚。今冲脉之气上逆,犯胃
则呕
吐涎沫,冲肺则咳呛不止。且冲脉即是血海,隶于阳明,细揣病情,治宜镇冲养胃。兹因腹
瘕呕恶,治以清肺平肝,方法极佳。如能酌用镇冲养胃之品,则奏效尤捷矣。
渔庄沈 大便已通,胃气稍振,脉虚细,舌滑白。宜养胃凝心神。(九月十二日。)
钗斛(三钱) 丹参(三钱) 谷芽(四钱) 新会皮(钱半) 省头草(三钱) 光杏仁(三钱)
远志(八分) 淡竹叶(钱半) 川贝(二钱) 抱木茯神(四钱) 合欢皮(三钱)
介按∶此是咳呛之后,肺胃津液未复,故以清肺养胃,兼安心神为治。
【医案一】
某患者:新感邪气引发咳嗽、气急,右胁部有刺痛感,应当预防咯血变证。(五月初三日)
干地龙(半钱) 枳壳(半钱) 金沸草(三钱) 光杏仁(三钱) 象贝母(三钱) 广郁金(三钱)
焦栀子(三钱) 马兜铃(一钱) 白前(半钱) 橘络(半钱) 前胡(半钱) 鲜竹茹(一丸)
服用两剂。
【医案二】
安昌徐姓患者:呛咳不止,脉象弦细,口中有甜味,舌色嫩黄。宜清泄肺胃以化痰。
瓜蒌皮(三钱) 仙半夏(半钱) 广橘红(一钱) 金沸花(三钱,包煎) 光杏仁(三钱)
炒黄连(七分) 茯苓(四钱) 石决明(五钱) 紫菀(半钱) 白前(半钱) 冬瓜子(三钱) 川贝母(半钱)
清水煎服,四剂。
邵介按语:肝热灼伤肺脏,脾湿酿生痰浊,此方清宣肺气,兼平肝热。又佐以渗湿化痰之法治疗。
【医案三】
某患者:咳嗽痰液不爽利,脉象弦,舌苔微白,脐下气机运行不畅。暂且以清气消痰为主治法。(四月二十三日)
瓜蒌皮(三钱) 霜桑叶(三钱) 金沸花(三钱,包煎) 炒枳壳(半钱) 川贝母(半钱) 石决明(六钱) 广郁金(一钱) 新会皮(半钱) 光杏仁(三钱) 白前(半钱) 焦栀子(三钱)
清水煎服,三剂。
邵介按语:肝阳逆乱阻滞枢机,导致肺气不宣。治疗以清宣肺痹,平肝理气,期望痰消肝和,诸病自愈。
【医案四】
安昌高姓患者:舌苔白滑,脉象细数,咳嗽痰迷,咯吐不易,气逆,周身骨节疼痛。宜防损伤之变。(五月二十三日)
北沙参(三钱) 生石决明(六钱) 甜杏仁(三钱) 炙甘草(八分) 茯苓(四钱) 川贝母(二钱) 怀山药(二钱) 冬瓜子(三钱) 生地(三钱) 紫菀(半钱) 盐水炒橘红(一钱)
清水煎服,五剂。
又诊:咳嗽未减,喉中贮留痰液不爽,咳吐不易,脉象濡细,舌苔滑,头晕肢体酸痛。宜清气熄风,利湿化痰。(六月初五日)
瓜蒌皮(三钱) 煨天麻(八分) 冬瓜子(三钱) 生石决明(四钱) 川贝母(三钱) 白蒺藜(三钱) 茯苓(四钱) 通草(半钱) 甘菊(半钱) 光杏仁(三钱) 广橘红(一钱)
清水煎服,四剂。
再诊:湿邪酿成痰浊,喉中咯吐不易,舌苔滑,大便不通畅。仍遵循前法加减。
瓜蒌皮(三钱) 金沸花(三钱,包煎) 川贝母(二钱) 通草(半钱) 广橘红(一钱) 广郁金(三钱) 杏仁(三钱) 焦山栀(三钱) 茯苓(四钱) 紫菀(半钱) 桑叶(三钱)
清水煎服,四剂。
邵介按语:肝阳上越,挟湿化痰,阻滞气机,导致咳嗽且咯痰不爽。初方健脾养胃,清肺渗湿;继则参入平肝熄风;终则清宣肺气,兼渗湿热。三方之中,次方尤为灵动。
【医案五】
某患者:湿热酿生痰浊,脉象濡细,舌苔微白,咳逆,右胁刺痛,小便赤,腹痛。宜清气、和络、化痰。
瓜蒌皮(三钱) 枳壳(半钱) 光杏仁(三钱) 降香(七分) 广郁金(三钱) 象贝母(三钱) 丝瓜络(三钱) 橘红(一钱) 干地龙(半钱) 通草(半钱) 白前(半钱)
清水煎服,二剂。
【医案六】
大西庄宋姓患者:呛咳喉痒,脉象弦细,舌苔转微白,潮热稍减,食后恶心。宜清肺胃化痰。(四月十六日,癸卯年二十九日)
紫菀(二钱) 光杏仁(三钱) 炒谷芽(四钱) 白前(半钱) 川贝母(半钱) 茯苓(四钱) 蔻壳(一钱) 橘红(一钱) 仙半夏(半钱) 青蒿梗(一钱) 通草(半钱)
清水煎服,三剂。
又诊:潮热不清,脉象弦细数,咳嗽如前,小便赤。宜清热、通肺、化痰,防咯血。(四月二十三日,甲辰年初七日)
秦艽(半钱) 霜桑叶(三钱) 白前(半钱) 焦山栀(三钱) 丹皮(二钱) 川贝母(二钱) 广橘红(一钱) 通草(半钱) 青蒿梗(一钱) 地骨皮(三钱) 杏仁(三钱)
清水煎服,三剂。
邵介按语:阴虚热盛,灼伤津液成痰而致咳嗽,现因舌苔转微白,继则小便变赤,属于更感新邪之候,肺胃屡次受创,肝阳上越无法制约。前后两方,既清内热,又祛新邪。但阴液骤难恢复,已属难治之症,后闻此人于六月十五左右竟至去世。记录此案作为辨证之一助。
【医案七】
遗风庞姓患者:咳嗽不已,脉象尚虚数,胃纳已调和。宜润肺以清降。(四月十二日)
生玉竹(三钱) 霜桑叶(三钱) 栝蒌皮(三钱) 马兜铃(一钱) 川贝母(半钱) 茯神(四钱) 光杏仁(三钱) 款冬花(三钱) 白前(半钱) 广橘络(半钱) 焦山栀(三钱) 生石决明(五钱)
清水煎服,四剂。
【医案八】
安昌施姓患者:咳嗽未除,脉象小数,仍有汗出,微热已退,暂宜清肺敛液。(五月一号,甲辰年十五日)
北沙参(三钱) 紫菀(二钱) 白薇(三钱) 白石英(三钱) 茯神(四钱) 川贝母(半钱) 炒白芍(半钱) 炙橘红(一钱) 生牡蛎(四钱) 甜杏仁(三钱) 炒枣仁(三钱)
清水煎服,四剂。
邵介按语:心在天对应热,其液为汗,现因心火不宁,刑克肺脏致咳嗽,气泄而身热汗出,故以补益心神,敛液清肺为治。
【医案九】
安昌王姓(年五十余岁):酒湿伤肺,咳嗽气急,痰稠,脉象滑数,舌赤,苔薄腻。尤防病情变幻,观察正气。(八月六日,丁未年二十四日)
瓜蒌皮(三钱) 广橘红(一钱) 原滑石(四钱) 炒知母(半钱) 象贝母(三钱) 天竺黄(半钱)
广郁金(三钱) 前胡(半钱) 光杏仁(三钱) 生莱菔子(二钱) 法半夏(半钱) (引药)枇杷叶(五片)
一剂。
邵介按语:酒湿酿痰,壅滞气机,肺失治节之权,而气急咳嗽,现以清肺气而涤稠痰,方虽对证。但高龄患此,属危险重症。案中“尤防变幻”之语,确是经验之谈。后闻此人,只过了四五日便逝世,可见医家临证,全在诊断确凿,审慎周详也。
【医案十】
安昌李姓(妇):呕吐减轻,热势缓和,呛咳渴饮,脉象滑数,月经停闭月余,小便稍利,偶有呃逆,脘痛。宜宣肺、和中、化痰。(九月补五日)
瓜蒌皮(三钱) 射干(半钱) 广橘白(一钱) 白前(二钱) 广郁金(三钱) 光杏仁(二钱) 焦山栀(三钱) 柿蒂(七只) 川贝母(二钱) 霜桑叶(三钱) 天花粉(三钱) (引药)枇杷叶(五片)
三剂。
又诊:呕逆已愈,脉象小滑,月经停闭月余,呛咳脘闷,气冲欲呕。宜清养肺胃化痰。(九月初九日)
黄草石斛(三钱) 川贝母(半钱) 大腹绒(三钱) 藿梗(二钱) 橘白(一钱) 扁豆衣(三钱) 广郁金(三钱) 绿萼梅(半钱) 桑叶(三钱) 炒谷芽(四钱) 蔻壳(半钱) 鲜枇杷叶(七片,去毛)
三剂。
又诊:呛咳未除,舌红,潮热,脉象滑数,经停,胸闷心悸。宜清养肺胃为主。(九月十三日)
南沙参(三钱) 冬桑叶(三钱) 橘红(一钱) 炒知母(半钱) 地骨皮(三钱) 川贝母(半钱)
谷芽(半钱) 绿萼梅(半钱) 银胡(一钱) 紫菀(二钱) 黄草石斛(三钱) 鲜枇杷叶(七片)
三剂。
邵介按语:肝经郁热上升,犯胃则呕恶呃逆,冲肺则咳呛脘闷,日久痰气凝滞,经络不宣。初方宣肺化痰,继则养胃清肝,终则又参入滋液退热。方法颇有次序。
【医案十一】
大西庄沈姓(妇):气喘呛咳,右脉小数,左关弦细,舌灰黄底红,月经不调,外寒内热,胃呆便秘。宜防咯血。(十月初九日)
霜桑叶(三钱) 光杏仁(三钱) 栝蒌皮(三钱) 南沙参(三钱) 川贝母(二钱) 甘菊(二钱) 焦山栀(三钱) 橘红(一钱) 紫菀(半钱) 白前(半钱) 谷芽(四钱) (引药)枇杷叶(五片,去毛)
三剂。
邵介按语:肝阴素亏,厥阳上冲肺胃,肺气失于清肃,以致咳喘而大便不爽,兼以阴虚内热,阳微外寒。治以清宣肺痹,养胃液而制肝逆。
【医案十二】
柯桥王姓:咳嗽较减,脉象虚,左脉弦细,腰疼,月经提前且量少涩滞,还宜前法加减为妥。
紫菀(二钱) 南沙参(三钱) 川断(三钱) 当归(半钱) 川贝母(半钱) 甜杏仁(三钱)
炒杜仲(二钱) 炒白芍(半钱) 丹皮(三钱) 橘络(半钱) 生地(四钱,砂仁五分拌炒) 小橘饼(三枚)
四剂。
邵介按语:经水提前,血热之征,脉虚腰疼,肾虚之候。咳嗽略减,是肺气略见清肃。脉虚而细,是胃液尚未恢复。故其方法,既以清养肺胃,又佐滋液补肾。
【医案十三】
遗风庞姓(妇):呛咳头晕,左脉弦细,气口搏大,形寒,胃呆,经停二月余。宜清肺胃熄风。(三月二十日,癸卯年初二日)
南沙参(三钱) 桔梗(半钱) 谷芽(四钱) 桑叶(三钱) 苏梗(半钱) 川贝母(二钱) 川断(三钱) 甘菊(半钱) 紫菀(二钱) 光杏仁(三钱) 炒杜仲(三钱)
清水煎服,四剂。
邵介按语:肝阳化风,旋扰不息,时届春令,肝阳愈旺,更受外风,逆乘肺胃,遂致呛咳头晕。现以柔肝养胃,清肺疏风,乃是对症疗法。
【医案十四】
遗风庞姓(妇):咳嗽稍减,腹中瘕块不利,呕恶涎沫,月经不及期。宜清肺、平肝、调经。
紫菀(半钱) 生牡蛎(四钱) 仙半夏(半钱) 茺蔚子(三钱) 川贝母(半钱) 香附(三钱)
广橘红(一钱) 玫瑰花(五朵) 甜杏仁(三钱) 钗石斛(三钱) 生款冬(三钱) 枇杷叶(五片,去毛)
四剂。
邵介按语:冲脉为病,气逆里急,在男子则为内疝,女子则为瘕聚。今冲脉之气上逆,犯胃则呕吐涎沫,冲肺则咳呛不止。且冲脉即是血海,隶于阳明,细揣病情,治宜镇冲养胃。兹因腹瘕呕恶,治以清肺平肝,方法极佳。如能酌用镇冲养胃之品,则奏效尤捷矣。
【医案十五】
渔庄沈姓:大便已通,胃气稍振,脉象虚细,舌苔滑白。宜养胃凝心神。(九月十二日)
钗石斛(三钱) 丹参(三钱) 谷芽(四钱) 新会皮(半钱) 省头草(三钱) 光杏仁(三钱)
远志(八分) 淡竹叶(半钱) 川贝母(二钱) 抱木茯神(四钱) 合欢皮(三钱)
[Case 1]
Patient: Cough and shortness of breath caused by a new pathogenic factor, stabbing pain in the right hypochondrium; prevention of hemoptysis is advised. (3rd day of the 5th lunar month)
*Earthworm* (0.5 qian), *Immature Bitter Orange* (0.5 qian), *Crabapple Flower* (3 qian), *Apricot Seed* (3 qian), *Fritillaria Thunbergii Bulb* (3 qian), *Curcuma Aromatica Rhizome* (3 qian),
*Scorched Gardenia Fruit* (3 qian), *Aristolochia Manshuriensis Stem* (1 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Tangerine Pith* (0.5 qian), *Peucedanum Przewalskii Root* (0.5 qian), *Fresh Bamboo Shavings* (1 pill).
Two doses.
Commentary by Shao Jie: This is lung damage due to warm pathogenic factors burning the lungs; thus, the treatment employs a formula to clear the lungs and calm the collaterals.
[Case 2]
Patient Xu from Anchang: Unremitting coughing with a choking sensation, wiry and fine pulse, sweet taste in the mouth, tender yellow tongue color. Clearing the Lung and Stomach to transform phlegm is indicated.
*Trichosanthes Peel* (3 qian), *Pinellia Ternata Rhizome* (0.5 qian), *Citrus Reticulata Pericarp* (1 qian), *Crabapple Flower* (3 qian, wrapped for decoction), *Apricot Seed* (3 qian),
*Stir-fried Coptis Chinensis Rhizome* (0.7 fen), *Poria Cocos* (4 qian), *Haliotidis Shell* (5 qian), *Aster Tataricus Root* (0.5 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Benincasa hispida Seed* (3 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian).
Decocted in water, four doses.
Commentary by Shao Jie: Liver heat burns the lungs, spleen dampness brews phlegm. This formula clears and diffuses Lung Qi, while simultaneously pacifying Liver heat. It is supplemented with methods to promote diuresis and transform phlegm.
[Case 3]
Patient: Cough with unsatisfactory expectoration, wiry pulse, slightly white tongue coating, stagnation of Qi mechanism below the umbilicus. Temporarily focusing on clearing Qi and eliminating phlegm is appropriate. (23rd day of the 4th lunar month)
*Trichosanthes Peel* (3 qian), *Mulberry Leaf* (3 qian), *Crabapple Flower* (3 qian, wrapped for decoction), *Stir-fried Immature Bitter Orange* (0.5 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Haliotidis Shell* (6 qian), *Curcuma Aromatica Rhizome* (1 qian), *Citrus Reticulata Pericarp* (0.5 qian), *Apricot Seed* (3 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Scorched Gardenia Fruit* (3 qian).
Decocted in water, three doses.
Commentary by Shao Jie: Rebellious Liver Yang obstructs the pivot mechanism, leading to non-diffusion of Lung Qi. Treatment involves clearing and diffusing Lung Bi (obstruction), pacifying the Liver, and regulating Qi, hoping that once phlegm is eliminated and the Liver harmonizes, all ailments will heal naturally.
[Case 4]
Patient Gao from Anchang: White and slippery tongue coating, fine and rapid pulse, cough with confused phlegm difficult to expectorate, rebellious Qi, pain in bone joints throughout the body. Prevention of consumption/damage is advised. (23rd day of the 5th lunar month)
*Glehnia Root* (3 qian), *Raw Haliotidis Shell* (6 qian), *Sweet Apricot Seed* (3 qian), *Prepared Licorice Root* (0.8 fen), *Poria Cocos* (4 qian), *Fritillaria Cirrhosa Bulb* (2 qian), *Dioscorea Hypoglauca Tuber* (2 qian), *Benincasa hispida Seed* (3 qian), *Rehmannia Glutinosa Root* (3 qian), *Aster Tataricus Root* (0.5 qian), *Salt-processed Citrus Reticulata Pericarp* (1 qian).
Decocted in water, five doses.
Second visit: Cough persists, phlegm accumulates in the throat and is difficult to expectorate, pulse is soggy and fine, tongue coating is slippery, dizziness and limb soreness. Clearing Qi, extinguishing wind, promoting dampness removal, and transforming phlegm are indicated. (5th day of the 6th lunar month)
*Trichosanthes Peel* (3 qian), *Calcined Gastrodia Elata Rhizome* (0.8 fen), *Benincasa hispida Seed* (3 qian), *Raw Haliotidis Shell* (4 qian), *Fritillaria Cirrhosa Bulb* (3 qian), *Tribulus Terrestris Fruit* (3 qian), *Poria Cocos* (4 qian), *Tetrapanax Papyrifer Stem* (0.5 qian), *Chrysanthemum Morifolium Flower* (0.5 qian), *Apricot Seed* (3 qian), *Citrus Reticulata Pericarp* (1 qian).
Decocted in water, four doses.
Third visit: Dampness has brewed into phlegm, difficult to expectorate from the throat, slippery tongue coating, unsmooth bowel movements. Continue with modifications of the previous method.
*Trichosanthes Peel* (3 qian), *Crabapple Flower* (3 qian, wrapped for decoction), *Fritillaria Cirrhosa Bulb* (2 qian), *Tetrapanax Papyrifer Stem* (0.5 qian), *Citrus Reticulata Pericarp* (1 qian), *Curcuma Aromatica Rhizome* (3 qian), *Apricot Seed* (3 qian), *Scorched Gardenia Fruit* (3 qian), *Poria Cocos* (4 qian), *Aster Tataricus Root* (0.5 qian), *Mulberry Leaf* (3 qian).
Decocted in water, four doses.
Commentary by Shao Jie: Rising Liver Yang carries dampness to form phlegm, obstructing the Qi mechanism, causing cough and difficulty in expectoration. The initial formula strengthened the Spleen and nourished the Stomach, clearing the Lungs and promoting dampness excretion; subsequently, it incorporated methods to pacify the Liver and extinguish wind; finally, it cleared and diffused Lung Qi while draining damp-heat. Among the three formulas, the second one is particularly agile.
[Case 5]
Patient: Phlegm brewed from damp-heat, soggy and fine pulse, slightly white tongue coating, rebellious cough, stabbing pain in the right hypochondrium, red urine, abdominal pain. Clearing Qi, harmonizing collaterals, and transforming phlegm are indicated.
*Trichosanthes Peel* (3 qian), *Immature Bitter Orange* (0.5 qian), *Apricot Seed* (3 qian), *Costus Root* (0.7 fen), *Curcuma Aromatica Rhizome* (3 qian), *Fritillaria Thunbergii Bulb* (3 qian), *Luffa Cylinrica Fiber* (3 qian), *Citrus Reticulata Pericarp* (1 qian), *Earthworm* (0.5 qian), *Tetrapanax Papyrifer Stem* (0.5 qian), *Cynanchum Stauntonii Root* (0.5 qian).
Decocted in water, two doses.
Commentary by Shao Jie: Damp-phlegm obstructing the Lungs causes chronic cough and hypochondriac pain; thus, treatment promotes dampness excretion and transforms phlegm while harmonizing the collaterals.
[Case 6]
Patient Song from Daxizhuang: Choking cough with itchy throat, wiry and fine pulse, tongue coating turning slightly white, tidal fever slightly reduced, nausea after eating. Clearing the Lung and Stomach to transform phlegm is indicated. (16th day of the 4th lunar month, 29th day of Gui Mao year)
*Aster Tataricus Root* (2 qian), *Apricot Seed* (3 qian), *Stir-fried Rice Sprout* (4 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Poria Cocos* (4 qian), *Amomum Villosum Fruit Shell* (1 qian), *Citrus Reticulata Pericarp* (1 qian), *Pinellia Ternata Rhizome* (0.5 qian), *Artemisia Annua Stem* (1 qian), *Tetrapanax Papyrifer Stem* (0.5 qian).
Decocted in water, three doses.
Second visit: Tidal fever not cleared, wiry, fine, and rapid pulse, cough as before, red urine. Clearing heat, unblocking the Lungs, and transforming phlegm are indicated, with prevention of hemoptysis. (23rd day of the 4th lunar month, 7th day of Jia Chen year)
*Gentiana Scabra Root* (0.5 qian), *Mulberry Leaf* (3 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Scorched Gardenia Fruit* (3 qian), *Moutan Cortex* (2 qian), *Fritillaria Cirrhosa Bulb* (2 qian), *Citrus Reticulata Pericarp* (1 qian), *Tetrapanax Papyrifer Stem* (0.5 qian), *Artemisia Annua Stem* (1 qian), *Bark of the Root of Rehmannia* (3 qian), *Apricot Seed* (3 qian).
Decocted in water, three doses.
Commentary by Shao Jie: Yin deficiency with excessive heat burns fluids to form phlegm, causing cough. Now, with the tongue coating turning slightly white and subsequent reddening of urine, this indicates contracting a new pathogenic factor. The Lung and Stomach have been repeatedly damaged, and unrestrained rising Liver Yang cannot be controlled. The previous two formulas both cleared internal heat and expelled new pathogens. However, Yin fluids are difficult to restore suddenly, making it a difficult-to-treat condition. Later, it was heard that this person passed away around the 15th day of the 6th lunar month. Recording this case serves as an aid to syndrome differentiation.
[Case 7]
Patient Pang from Yifeng: Unremitting cough, pulse still deficient and rapid, stomach appetite has harmonized. Moistening the Lungs to clear and descend is indicated. (12th day of the 4th lunar month)
*Polygonatum Odoratum Rhizome* (3 qian), *Mulberry Leaf* (3 qian), *Trichosanthes Peel* (3 qian), *Aristolochia Manshuriensis Stem* (1 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Poria Cocos with Hostwood* (4 qian), *Apricot Seed* (3 qian), *Adenophora Stricta Flower Bud* (3 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Tangerine Pith* (0.5 qian), *Scorched Gardenia Fruit* (3 qian), *Raw Haliotidis Shell* (5 qian).
Decocted in water, four doses.
Commentary by Shao Jie: This formula clears the Lungs and nourishes the Stomach to soften the Liver, serving as an excellent remedy for post-cough recovery.
[Case 8]
Patient Shi from Anchang: Cough persists, small and rapid pulse, sweating continues, slight fever has subsided. Temporarily clearing the Lungs and astringing fluids is appropriate. (1st day of the 5th lunar month, 15th day of Jia Chen year)
*Glehnia Root* (3 qian), *Aster Tataricus Root* (2 qian), *Anemone Radicle* (3 qian), *White Quartz* (3 qian), *Poria Cocos with Hostwood* (4 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Stir-fried White Peony Root* (0.5 qian), *Roasted Citrus Reticulata Pericarp* (1 qian), *Raw Oyster Shell* (4 qian), *Sweet Apricot Seed* (3 qian), *Stir-fried Ziziphus Spinosa Seed* (3 qian).
Decocted in water, four doses.
Commentary by Shao Jie: In Heaven, the Heart corresponds to Heat, and its fluid is sweat. Now, due to restless Heart Fire punishing the Lungs causing cough, Qi leakage leads to body heat and sweating. Thus, treatment tonifies the Heart Spirit, astringes fluids, and clears the Lungs.
[Case 9]
Patient Wang from Anchang (over 50 years old): Alcohol-dampness injuring the Lungs, cough with shortness of breath, thick phlegm, slippery and rapid pulse, red tongue, thin greasy coating. Special attention should be paid to preventing changes in condition; observe the righteous Qi. (6th day of the 8th lunar month, 24th day of Ding Wei year)
*Trichosanthes Peel* (3 qian), *Citrus Reticulata Pericarp* (1 qian), *Raw Talcum* (4 qian), *Stir-fried Anemarrhena Asphodeloides Rhizome* (0.5 qian), *Fritillaria Thunbergii Bulb* (3 qian), *Bambusa Textilis Tuber* (0.5 qian),
*Curcuma Aromatica Rhizome* (3 qian), *Peucedanum Przewalskii Root* (0.5 qian), *Apricot Seed* (3 qian), *Raw Radish Seed* (2 qian), *Processed Pinellia Ternata Rhizome* (0.5 qian). (Guiding herb) *Loquat Leaf* (5 leaves).
One dose.
Commentary by Shao Jie: Alcohol-dampness brews phlegm, obstructing the Qi mechanism, causing the Lung to lose its regulatory power, resulting in shortness of breath and cough. Now, clearing Lung Qi and washing away thick phlegm, the formula matches the syndrome. However, for an elderly person, this is a dangerous severe condition. The phrase "special attention to preventing changes" in the case record is indeed experiential wisdom. Later, it was heard that this person passed away after only four or five days. This shows that clinical practice relies entirely on accurate diagnosis and careful deliberation.
[Case 10]
Patient Li from Anchang (female): Vomiting reduced, fever eased, choking cough with thirst, slippery and rapid pulse, amenorrhea for over a month, urination slightly improved, occasional hiccups, epigastric pain. Diffusing the Lungs, harmonizing the Middle, and transforming phlegm are indicated. (Supplementary 5th day of the 9th lunar month)
*Trichosanthes Peel* (3 qian), *Belamcanda Chinensis Rhizome* (0.5 qian), *Citrus Reticulata Albedo* (1 qian), *Cynanchum Stauntonii Root* (2 qian), *Curcuma Aromatica Rhizome* (3 qian), *Apricot Seed* (2 qian), *Scorched Gardenia Fruit* (3 qian), *Persimmon Calyx* (7 pieces), *Fritillaria Cirrhosa Bulb* (2 qian), *Mulberry Leaf* (3 qian), *Trichosanthes Root* (3 qian). (Guiding herb) *Loquat Leaf* (5 leaves).
Three doses.
Second visit: Nausea and vomiting have ceased, pulse is small and slippery, amenorrhea for over a month, choking cough with epigastric stuffiness, Qi rushing up causing urge to vomit. Clearing and nourishing the Lung and Stomach to transform phlegm is indicated. (9th day of the 9th lunar month)
*Dendrobium Officinale Stem* (3 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Areca Seed* (3 qian), *Agastache Rugosus Stem* (2 qian), *Citrus Reticulata Albedo* (1 qian), *Dolichos Lablab Seed Coat* (3 qian), *Curcuma Aromatica Rhizome* (3 qian), *Green-calix Plum* (0.5 qian), *Mulberry Leaf* (3 qian), *Stir-fried Rice Sprout* (4 qian), *Amomum Villosum Fruit Shell* (0.5 qian), *Fresh Loquat Leaf* (7 pieces, de-haired).
Three doses.
Third visit: Choking cough persists, red tongue, tidal fever, slippery and rapid pulse, amenorrhea, chest stuffiness and palpitations. Clearing and nourishing the Lung and Stomach is primarily indicated. (13th day of the 9th lunar month)
*Glehnia Root* (3 qian), *Mulberry Leaf* (3 qian), *Citrus Reticulata Pericarp* (1 qian), *Stir-fried Anemarrhena Asphodeloides Rhizome* (0.5 qian), *Bark of the Root of Rehmannia* (3 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian),
*Rice Sprout* (0.5 qian), *Green-calix Plum* (0.5 qian), *Silver Birch Bark* (1 qian), *Aster Tataricus Root* (2 qian), *Dendrobium Officinale Stem* (3 qian), *Fresh Loquat Leaf* (7 pieces).
Three doses.
Commentary by Shao Jie: Depressed Heat in the Liver Channel rises; invading the Stomach causes nausea, vomiting, and hiccups; rushing to the Lungs causes choking cough and epigastric stuffiness. Over time, phlegm and Qi stagnate, and meridians do not diffuse. The first formula diffused the Lungs and transformed phlegm; the next nourished the Stomach and cleared the Liver; finally, it incorporated methods to nourish fluids and reduce fever. The methodology is well-ordered.
[Case 11]
Patient Shen from Daxizhuang (female): Asthma and choking cough, right pulse small and rapid, left Guan position wiry and fine, tongue gray-yellow with red base, irregular menstruation, external cold with internal heat, gastric dullness and constipation. Prevention of hemoptysis is advised. (9th day of the 10th lunar month)
*Mulberry Leaf* (3 qian), *Apricot Seed* (3 qian), *Trichosanthes Peel* (3 qian), *Glehnia Root* (3 qian), *Fritillaria Cirrhosa Bulb* (2 qian), *Chrysanthemum Morifolium Flower* (2 qian), *Scorched Gardenia Fruit* (3 qian), *Citrus Reticulata Pericarp* (1 qian), *Aster Tataricus Root* (0.5 qian), *Cynanchum Stauntonii Root* (0.5 qian), *Rice Sprout* (4 qian). (Guiding herb) *Loquat Leaf* (5 leaves, de-haired).
Three doses.
Commentary by Shao Jie: Chronic Liver Yin deficiency allows Jue Yang to rush up to the Lung and Stomach, causing the Lung Qi to lose its clarity and descending function, resulting in cough and asthma with unsmooth bowel movements. Accompanied by Yin deficiency with internal heat and slight Yang deficiency with external cold. Treatment clears and diffuses Lung Bi, nourishes Stomach fluids, and controls Liver rebellion.
[Case 12]
Patient Wang from Keqiao: Cough has decreased somewhat, pulse is deficient, left pulse is wiry and fine, lower back pain, menstruation arrived early and was scanty/stagnant. Modifying the previous method is appropriate.
*Aster Tataricus Root* (2 qian), *Glehnia Root* (3 qian), *Drynaria Fortunei Rhizome* (3 qian), *Angelica Sinensis Root* (0.5 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Sweet Apricot Seed* (3 qian),
*Stir-fried Eucommia Ulmoides Bark* (2 qian), *Stir-fried White Peony Root* (0.5 qian), *Moutan Cortex* (3 qian), *Tangerine Pith* (0.5 qian), *Rehmannia Glutinosa Root* (4 qian, stir-fried with 0.5 fen Amomum Tsao-ko Seed), *Small Tangerine Cake* (3 pieces).
Four doses.
Commentary by Shao Jie: Early menstruation is a sign of Blood Heat; deficient pulse and lower back pain are signs of Kidney Deficiency. Slight reduction in cough indicates slight restoration of Lung Qi clarity. Deficient and fine pulse indicates Stomach fluids have not yet recovered. Thus, the method clears and nourishes the Lung and Stomach, assisted by nourishing fluids and tonifying the Kidney.
[Case 13]
Patient Pang from Yifeng (female): Choking cough with dizziness, left pulse wiry and fine, Qi Kou pulse beats strongly, aversion to cold, gastric dullness, amenorrhea for over two months. Clearing the Lung and Stomach and extinguishing wind is indicated. (20th day of the 3rd lunar month, 2nd day of Gui Mao year)
*Glehnia Root* (3 qian), *Platycodon Grandiflorus Root* (0.5 qian), *Rice Sprout* (4 qian), *Mulberry Leaf* (3 qian), *Perilla Stem* (0.5 qian), *Fritillaria Cirrhosa Bulb* (2 qian), *Drynaria Fortunei Rhizome* (3 qian), *Chrysanthemum Morifolium Flower* (0.5 qian), *Aster Tataricus Root* (2 qian), *Apricot Seed* (3 qian), *Stir-fried Eucommia Ulmoides Bark* (3 qian).
Decocted in water, four doses.
Commentary by Shao Jie: Liver Yang transforms into wind, swirling incessantly. In spring, Liver Yang becomes even stronger, compounded by external wind, which rebels against the Lung and Stomach, causing choking cough and dizziness. Now, softening the Liver and nourishing the Stomach, clearing the Lungs and dispersing wind constitutes symptomatic treatment.
[Case 14]
Patient Pang from Yifeng (female): Cough slightly reduced, abdominal mass causing discomfort, vomiting of saliva and foam, menstruation arrived ahead of schedule. Clearing the Lung, pacifying the Liver, and regulating menstruation is indicated.
*Aster Tataricus Root* (0.5 qian), *Raw Oyster Shell* (4 qian), *Pinellia Ternata Rhizome* (0.5 qian), *Leonurus Japonicus Fruit* (3 qian), *Fritillaria Cirrhosa Bulb* (0.5 qian), *Cyperi Rhizoma* (3 qian),
*Citrus Reticulata Pericarp* (1 qian), *Rose Flower* (5 petals), *Sweet Apricot Seed* (3 qian), *Dendrobium Nobile Stem* (3 qian), *Raw Adenophora Stricta Flower Bud* (3 qian), *Loquat Leaf* (5 leaves, de-haired).
Four doses.
Commentary by Shao Jie: Disease of the Chong Mai involves rebellious Qi and inner urgency; in men, it manifests as internal hernia; in women, as abdominal masses. Now, Qi of the Chong Mai rebels upward; invading the Stomach causes vomiting of saliva and foam; rushing to the Lungs causes unremitting choking cough. Moreover, the Chong Mai is the Sea of Blood, subordinate to the Yangming. Carefully analyzing the condition, treatment should suppress the Chong Mai and nourish the Stomach. Here, due to abdominal mass and vomiting, treatment clears the Lung and pacifies the Liver, which is an excellent method. If items to suppress the Chong Mai and nourish the Stomach were酌情 added, efficacy would be even more rapid.
[Case 15]
Patient Shen from Yuzhuang: Bowel movement has opened, Stomach Qi slightly revived, pulse is deficient and fine, tongue coating is slippery and white. Nourishing the Stomach and calming the Spirit is indicated. (12th day of the 9th lunar month)
*Dendrobium Nobile Stem* (3 qian), *Salvia Miltiorrhiza Root* (3 qian), *Rice Sprout* (4 qian), *Citrus Reticulata Pericarp* (0.5 qian), *Agastache Rugosus Herb* (3 qian), *Apricot Seed* (3 qian),
*Polygala Tenuifolia Root* (0.8 fen), *Light Bamboo Leaf* (0.5 qian), *Fritillaria Cirrhosa Bulb* (2 qian), *Poria Cocos with Hostwood* (4 qian), *Albizia Julibrissin Bark* (3 qian).
Commentary by Shao Jie: After choking cough, Lung and Stomach fluids have not yet recovered; thus, treatment clears the Lungs and nourishes the Stomach, while also calming the Spirit.